Cervical Cancer Literacy and Screening Adherence among Female University Staff in Iraq: A Correlational Study
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Objective: To examine the association between cervical cancer health literacy and adherence to preventive cervical cancer screening among female university staff in Karbala, Iraq.
Methods and Materials: A cross-sectional correlational study was conducted in January 2025 at the University of Karbala. Using simple random sampling from staff lists, 285 female employees (20–65 years) completed a structured questionnaire including: (1) an Arabic-translated and content-validated Cervical Cancer Awareness Measure (CCAM), and (2) an adherence-to-screening scale. Content validity was assessed by 17 experts; internal consistency was acceptable/excellent (Cronbach’s alpha reported in the manuscript). Data were analyzed using descriptive statistics, Pearson’s correlation, and simple linear regression (SPSS v26).
Findings: Most participants demonstrated high cervical cancer literacy (mean ≈ 37.46 ± 5.76; 64.2% high). Screening adherence was mostly moderate (mean ≈ 15.97 ± 3.11; 57.2% moderate; 22.1% low). Cervical cancer literacy showed a significant positive correlation with screening adherence (r ≈ 0.260, p < 0.01). In regression analysis, literacy significantly predicted adherence (β ≈ 0.260; p < 0.001), explaining about 6.8% of variance (R² ≈ 0.068)
Conclusion: Higher cervical cancer health literacy was associated with better screening adherence, yet adherence remained suboptimal despite generally high literacy. Multi-level, culturally tailored interventions beyond information provision—addressing barriers, motivation, and service access—are recommended to improve screening uptake.
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Abd Ali, A. M., & Musihb, Z. S. (2024). Mothers’ practices in prevention of sudden infant death syndrome in Holy Kerbala City. Iranian Rehabilitation Journal, 22(1), 75-82. https://doi.org/10.32598/irj.22.1.1619.4
Al-Abedi, G. A., Mansoor, H. I., & Faris, S. H. (2024). Older Adult Self-care and Related Factors at Primary Health Care Centers. Bahrain Medical Bulletin, 46(1).
Arbyn, M., Gultekin, M., Morice, P., Nieminen, P., Cruickshank, M., Poortmans, P., Kelly, D., Poljak, M., Bergeron, C., & Ritchie, D. (2021). The European response to the WHO call to eliminate cervical cancer as a public health problem. International Journal of Cancer, 148(2), 277-284. https://doi.org/10.1002/ijc.33189
Ayamolowo, S. J., Akinrinde, L. F., Oginni, M. O., & Ayamolowo, L. B. (2020). The influence of health literacy on knowledge of cervical cancer prevention and screening practices among female undergraduates at a university in Southwest Nigeria. Africa Journal of Nursing and Midwifery, 22(1), 14 pages-14 pages. https://doi.org/10.25159/2520-5293/6615
Banks, K. S., James, C. M., Nganwa, D., Heath, J., Webb, L., Elhussin, I., Faraj, R., & Abdalla, E. (2022). Knowledge and awareness about cervical cancer and Human Papillomavirus among women living in Macon County, Alabama. Journal of Healthcare, Science and the Humanities, 12(1), 13.
Dost, A., & Özdemir, İ. N. (2024). Women’s Health Literacy Levels and Health Beliefs Concerning Cervical Cancer and Pap Smear Test in Türkiye. Medical Journal of Bakirkoy. https://doi.org/10.4274/BMJ.galenos.2024.2023.6-3
Dozie, U. W., Ezeala, O. V., David, C. I., Dozie, K. C. N., Chukwuocha, U. M., Iwuala, C. C., Osuoji, N. J., Okoro, C. C., Chukwu, O. R., & Eneh, S. C. (2023). Factors associated with health seeking delay in the screening of cervical cancer among women in Imo state, south Eastern Nigeria. Cancer Treatment and Research Communications, 37, 100765. https://doi.org/10.1016/j.ctarc.2023.100765
Endale, H., Mulugeta, T., & Habte, T. (2022). The socioeconomic impact of cervical cancer on patients in Ethiopia: evidence from tikur anbessa specialized hospital. Cancer management and research, 1615-1625. https://doi.org/10.2147/CMAR.S352389
Foroutan, Y., & Bijani, H.-R. (2021). Childlessness in Iran: Findings and solutions. Journal of Population Association of Iran, 16(32), 177-203.
Huang, Q., & Tan, L.-Y. (2024). Exploring Factors Influencing Cervical Cancer Screening Participation among Singaporean Women: A Social Ecological Approach. Cancers, 16(20), 3475. https://doi.org/10.3390/cancers16203475
Ibrahim-Ojoawo, A., Powe, N., Rogers, R., Learman, K., & Hefner, H. (2024). A Cross-Sectional Analysis of 2017-2022 National Immunization Survey: Sociodemographic Disparities Associated With Human Papillomavirus Vaccine Initiation and Completion Series Among US Adolescents. Cancer Control, 31, 10732748241293674. https://doi.org/10.1177/10732748241293674
Jasim, R. N., & Oleiwi, S. S. (2023). Knowledge of Iraqi girls towards polycystic ovary syndrome. Health, 2, 1-14.
Mansoor, H. I., & Yasir, A. A. (2016). Evaluation of the activities of health promotion and communicable disease staff for the control of cholera epidemic in Al-Hilla city. International Journal of PharmTech Research, 9(11).
Mekonen, E. G., Gebrehana, D. A., & Tamir, T. T. (2024). Determinants of cervical cancer screening among women of childbearing age in four sub-Saharan African countries: insights from large population surveys. BMC cancer, 24(1), 1304. https://doi.org/10.1186/s12885-024-13079-8
Nwafor-Orizu, E. O., Umunnakwe, G. C., & Onwudinjo, O. T. (2018). Cervical Cancer Health Literacy Among Female Librarians in Imo State, Nigeria. Library Philosophy & Practice.
Richards, M. (2009). The national awareness and early diagnosis initiative in England: assembling the evidence. British journal of cancer, 101(Suppl 2), S1. https://doi.org/10.1038/sj.bjc.6605382
Rimande-Joel, R., & Ekenedo, G. O. (2019). Knowledge, Belief and practice of cervical cancer screening and prevention among women of Taraba, North-East Nigeria. Asian Pacific journal of cancer prevention: APJCP, 20(11), 3291. https://doi.org/10.31557/APJCP.2019.20.11.3291
Riza, E., Karakosta, A., Tsiampalis, T., Lazarou, D., Karachaliou, A., Ntelis, S., Karageorgiou, V., & Psaltopoulou, T. (2020). Knowledge, attitudes and perceptions about cervical cancer risk, prevention and human papilloma virus (HPV) in vulnerable women in Greece. International Journal of Environmental Research and Public Health, 17(18), 6892. https://doi.org/10.3390/ijerph17186892
Rubin, L., Okitondo, C., Haines, L., & Ebell, M. (2023). Interventions to increase colorectal cancer screening adherence in low-income settings within the United States: A systematic review and meta-analysis. Preventive Medicine, 172, 107522. https://doi.org/10.1016/j.ypmed.2023.107522
Sobotka, T., Skirbekk, V., & Philipov, D. (2011). Economic recession and fertility in the developed world. Population and development review, 37(2), 267-306. https://doi.org/10.1111/j.1728-4457.2011.00411.x
Soeung, S. C., Komagata, T., Darapheack, C., Kikuchi, S., Obara, H., Haruyama, R., Kanal, K., Fujita, N., Yanaihara, N., & Okamoto, A. (2022). Knowledge and practice for cervical cancer among female primary school teachers in Phnom Penh, Cambodia: A cross-sectional phone-based survey. GHM open, 2(1), 25-30. https://doi.org/10.35772/ghmo.2022.01005
Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., Brand, H., & European, C. H. L. P. (2012). Health literacy and public health: a systematic review and integration of definitions and models. BMC public health, 12(1), 80. https://doi.org/10.1186/1471-2458-12-80
Stroetmann, C. Y., Gizaw, M., Alemayehu, R., Wondimagegnehu, A., Rabe, F., Santos, P., Mchome, B., Mmbaga, B. T., Addissie, A., & Kantelhardt, E. J. (2024). Adherence to Treatment and follow-up of precancerous cervical lesions in Ethiopia. The Oncologist, 29(5), e655-e664. https://doi.org/10.1093/oncolo/oyae027
Tatar, O., Haward, B., Perez, S., Zhu, P., Brotherton, J., Decker, K., Lofters, A. K., Mayrand, M.-H., McBride, E., & Ogilvie, G. (2024). On the path toward cervical cancer elimination in Canada: a national survey of factors influencing women's intentions to participate in human papillomavirus test-based primary cervical screening. The Lancet Regional Health–Americas, 39. https://doi.org/10.1016/j.lana.2024.100901
Tekle, T., Wolka, E., Nega, B., Kumma, W. P., & Koyira, M. M. (2020). Knowledge, attitude and practice towards cervical cancer screening among women and associated factors in hospitals of Wolaita Zone, Southern Ethiopia. Cancer management and research, 993-1005. https://doi.org/10.2147/CMAR.S240364
Urstad, K. H., Andersen, M. H., Larsen, M. H., Borge, C. R., Helseth, S., & Wahl, A. K. (2022). Definitions and measurement of health literacy in health and medicine research: a systematic review. BMJ open, 12(2), e056294. https://doi.org/10.1136/bmjopen-2021-056294
Yirsaw, A. N., Tefera, M., Bogale, E. K., Anagaw, T. F., Tiruneh, M. G., Fenta, E. T., Endeshaw, D., Adal, O., Tareke, A. A., & Jemberu, L. (2024). Applying the Health Belief Model to cervical cancer screening uptake among women in Ethiopia: a systematic review and meta-analysis. BMC cancer, 24(1), 1294. https://doi.org/10.1186/s12885-024-13055-2
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